Janice Fravel likely never dreamed she one day would be the first person in the area to undergo a procedure for an extremely rare heart condition.
Fravel, 75, of Jersey Shore, was active and healthy for most of her life, until several years ago when she started to not quite feel herself.
“I was real active,” she said. “I walked 4 or 5 miles ever day. Then, pretty soon I couldn’t walk 2 miles. Then I couldn’t walk up the hill.”
She lost much of her energy, felt weaker, and at times couldn’t catch her breath.
Eventually, she was treated for atrial fibrillation, but that didn’t seem to help.
She underwent a series of tests and even was hospitalized for a time earlier this year.
And then, something a little bit different was found wrong.
It was determined that Fravel had a condition known as coronary fistula.
Dr. Michael Lazar, a Susquehanna Health cardiothoracic surgeon and medical director of Williamsport Regional Medical Center, noted that blood was being pumped into her heart chamber, creating a backflow with nearly 1.25 liters of blood bypassing the normal circuit. That was enlarging her arteries and putting her at risk for hemorrhaging or clots.
The abnormal connection, or fistula, likely caused Fravel’s arrhythmia.
In a normal connection, blood in the artery flows to veins and capillaries and away from the heart.
“Coronary fistulas are rare – that’s about 1 percent of cases, and the location of Janice’s was even more unique – the most rare of a very rare condition,” Lazar said.
Only about 20 such procedures had ever been done in the U.S. However, through the health system’s affiliation with Cleveland Clinic, Lazar was able to confer with some of the top heart specialists to determine how to proceed.
He felt sure he could perform the procedure needed to help Fravel.
“I have a lot of experience with advanced coronary procedures, and I had every confidence in our facility. The team here is as good as any team I’ve ever worked with. All of the components are in place,” Lazar said. “Having the ECMO (a machine that can take over the work of the lungs and heart) was a significant factor, because we could support her heart and lung function indefinitely to transfer her to Cleveland Clinic if we needed to.”
Fravel, who underwent the successful hour-long surgical procedure June 5 at Williamsport Regional Medical Center, called it a “miracle.”
“I just feel like I got a new lease on life,” she said.
She has resumed most of her daily activities that she has long enjoyed – playing with grandchildren, delivering meals to shut-ins, resuming her active church life.
A coronary fistula is often congenital, and it’s likely that Fravel had the condition for a very long time
However, it’s often not diagnosed until later in life.
For Fravel, it was a condition she had no way of even knowing she had until she began feeling its symptoms several years ago.
“She was relatively healthy most of her life,” Lazar said. “She was active. That helped her survive so long.”